Outdoors: Care Is Needed to Avoid Lyme Disease

By NELSON BRYANT

Published: April 25, 1988

LYME disease, a tick-transmitted malady that can result in severe and prolonged arthritic symptoms and neurological and heart disorders, is spreading rapidly in southern New England, New York and New Jersey.

In New York's Westchester County alone, there were 545 reported instances of the disease last year, an increase of 252 from 1986, and the current rate of new cases is about three times as high as it was in 1987.

Those whose wanderings take them into forest, brushy areas or wild meadows undoubtedly run more risk of being bitten by a disease-bearing tick than those who rarely stray from their own backyards. But ticks have a knack for being almost ubiquitous, and can also be brought into a home by a dog or cat.

The illness - originally called Lyme arthritis - was first identified in the Lyme, Conn., area in the mid-1970's. There have been cases of it in Wisconsin and Minnesota, and, to a lesser extent, in California and Oregon. In addition, Long Island has been hard hit, as have Cape Cod and the Massachusetts islands of Martha's Vineyard, Nantucket and Cuttyhunk.

Responding to this threat, the New York-New Jersey Trail Conference -whose members spend much of their spare time hiking on or maintaining some 800 miles of trails in the two-state region - devoted a recent meeting to Lyme disease. The Conference's speaker was Dr. Albert P. Rosen, a pediatrician from Fair Lawn, N.J., and a longtime hiker.

Lyme disease is transmitted by the bite of the so-called deer tick, Ioxdes dammini, a tiny insect about the size of the head of a pin. ''Bite'' is something of a misnomer, for the tick doesn't nip and depart but buries its head in the host and feeds on its blood, sometimes remaining for several days. The deer tick is much smaller than the common dog tick that is also found on household pets. Fully engorged, the dog tick is often as large as a cranberry.

Dr. Rosen says that those bitten by a tick might develop symptoms of Lyme disease from three days to two weeks later. In some instances, he adds, the tick may have gone unnoticed. Early reactions usually include a spreading rash around the area of the bite, as well as flu-like symptoms.

Most instances of the disease occur in summer, although the ticks may appear on domestic pets in early March in southern New England and elsewhere in the Northeast.

According to Dr. Joseph Craft of the Yale School of Medicine, the disease may be transmitted by other small ticks, but this is most unusual. The dog tick has never been implicated in this. The whitetail deer is the primary host of the adult state of Ioxdes dammini, and the white-footed mouse - which transmits the disease to the tick - plays the same role for the insect's larval and nymph stages.

The female deer tick, most often in the nymph phase but also in the larval and adult phases, is the bearer of Lyme disease. Because only about half of all deer ticks carry the disease-causing spirochete, merely finding one imbedded in your flesh doesn't mean that you will become ill, and even if the tick is a carrier, the disease is contracted less than half the time. Because of this, Dr. Craft and his associates - Yale Medical School has been a leader in Lyme disease research - do not ''routinely recommend'' beginning treatment simply because someone is bitten by a tick.

For several years, penicillin was the antibiotic of choice. Although it is still used, Dr. Craft says that tetracycline or amoxicillin is now usually administered in the early stages of the disease, with either intravenous ceftriaxone or intravenous penicillin being given later if neurological or arthritic disorders develop.

Individuals vary a great deal in their reactions to Lyme disease. Some experience only minor discomfort. In other instances, the aforementioned symptoms may persist or recur for more than a year.

Deer and dog ticks are found in brush, forests, and uncut fields. A short stroll in a tick-infested meadow where the grass is knee-high will often result in several of the insects of both varieties getting on your trousers or legs. They may also be found crawling on blades of beach grass.

Those who live in or visit Lyme-disease areas needn't panic, but they should get into the habit of looking for ticks on their bodies and clothing immediately after an outing. One can lessen the chances of playing host to a tick by wearing a long-sleeved shirt and long pants, shoes and socks. Tuck the pant legs into the socks. If one wishes to refine this further, an all-white ensemble makes spotting the critters much easier. For many people, such over-dressing may prove too onerous, and for them the end of the day inspection is all-important.

Ticks that get on your bare legs usually move to the groin area or the upper half of your body before digging in. They are often detected during that passage by a tickling sensation. A shower and shampoo immediately after every outing helps remove ticks that haven't begun to feed. When feeding is under way, they have to be pulled from your flesh.

Because the average person isn't capable of telling one tick from another, Dr. Rosen recommends that all ticks that are fastened to your flesh be treated as potential sources of Lyme disease. By always using tweezers to remove a tick, he says, the entire insect, including its biting apparatus, can be extracted. This also applies, he says, to the de-ticking of dogs and cats, adding that dogs have been known to become infected by Lyme disease. Dr. Rosen suggests saving a tick you have pulled from your flesh because the tick's disease-bearing spirochetes can be detected in a laboratory.

Although this is of little relevance to the serious hiker, an environmentally-safe system - called Damminix - to curb deer tick populations has been developed by Harvard University's School of Public Health. Biodegradable cardboard tubes containing cotton balls treated with the insecticide permethrin are distributed about one's grounds. The balls are used by white-footed mice for nest-building. The permethrin kills the ticks that are using the mice as a host but does not harm the latter.

Damminix is expensive; 100 tubes, enough for treating one acre for one year, cost about $400. One would treat only the space that provides habitat for mice. Lawns would, for example, be excluded. Damminix literature is available from EcoHealth, Inc., 33 Mount Vernon St., Boston, Mass. 02108, (617) 742-2400.